Incidents dermatitis

Measures of the public health importance of a disease include the absolute number of cases, the incidence rate, the prevalence (rate), the economic impact of the disease, and the prognosis and preventability of the disease.65 Contact dermatitis is the most common occupational and environmental skin disease. Epidemiologic data show that contact dermatitis comprises 90 to 95% of all occupational skin diseases. 

A concern with the administration of lamotrigine is that it has the potential to induce the Stevens-Johnson syndrome (exfoliative dermatitis). The incidence of a serious rash in clinical trials appears to be about 0.08% with monotherapy and 0.13% with combination therapy. The rash usually resolves when lamotrigine is stopped, but all patients starting lamotrigine should be cautioned to be vigilant for the development of a rash, especially during the first 6 months of treatment. 

Chronic exposures to 250 and 500 mg/kg/day of both marine diesel fuel and JP-5 induced dermatitis and ulcerations of the skin in mice (NTP/NIH 1986). The incidence and severity of dermatitis and the incidence of ulcers induced by marine diesel fuel were dose dependent for the chronic exposures. The severity, but not the incidence, of dermatitis induced by JP-5 was dose dependent for the chronic exposures. Also, the incidence of ulcers was dose dependent in chronic studies with JP-5. Dermatitis was also noted in another study in mice that were chronically exposed to either JP-5 or marine diesel fuel effective doses were not reported (Easley et al. 1982). 

A negative result in this type of test indicates that the potential to sensitise is extremely low and that human exposure is unlikely to be attended by a significant incidence of sensitisation. Because the test can be overpredictive, some toxicologists recommend that a non-adjuvant test such as the Buehler test should be used if a positive is obtained, to give a more realistic determination of the prevalence of human sensitisation, it should be remembered that contact sensitisation is a persistent condition thus once sensitised to a chemical, an individual is at risk of dermatitis whenever exposed to the same or antigenically cross-reactive chemical, for example, nickel in jewellery. 

Certain industrial populations exposed to coal tar products have a demonstrated risk of skin cancer. Substances containing polycyclic hydrocarbons or polynuclear aromatics (PNAs), which may produce skin cancer, also produce contact dermatitis (e.g., coal tar pitch, cutting oils)." Although allergic dermatitis is readily induced by PNAs in guinea pigs, it only rarely is reported in humans from occupational contact with PNAs. Incidences in humans have resulted largely from the therapeutic use of coal tar preparations. ... 

In a lifetime study, 25-pi aliquots of a 5% solution applied three times a week to the skin of male mice caused a low incidence of dermatitis, hyperkeratosis, and necrosis. There... 

In humans, contact dermatitis was observed in 90% of factory workers handling DAB. There have been no reports of an increased cancer incidence among exposed persons. ... 

Adverse effects resulting from gold-accumulation in tissues can include lesions of the mucous membranes, skin eruptions varying from erythema to severe exfoliative dermatitis, proteinuria and nephrosis. A serious hematologic reaction is aplastic anemia. A rather high incidence of gastrointestinal disturbances is seen in patients on auranofin. 

The incidence of adverse effects with hydroquinone increases in proportion to its concentration. A relatively common side effect is local irritation, which may actually exacerbate the discoloration of the skin being treated. Allergic contact dermatitis occurs less commonly. A rare but more serious complication is exogenous ochronosis, in which a yellow-brown pigment deposited in the dermis results in blue-black pigmentation of the skin that may be permanent. 

Many congeners of phenytoin have been synthesized, but only three have been marketed in the USA, and one of these (phenacemide) has been withdrawn. The other two congeners, mephenytoin and ethotoin, like phenytoin, appear to be most effective against generalized tonic-clonic seizures and partial seizures. No well-controlled clinical trials have documented their effectiveness. The incidence of severe reactions such as dermatitis, agranulocytosis, or hepatitis is higher for mephenytoin than for phenytoin. 

Sulfasalazine has a high incidence of adverse effects, most of which are attributable to systemic effects of the sulfapyridine molecule. Slow acetylators of sulfapyridine have more frequent and more severe adverse effects than fast acetylators. Up to 40% of patients cannot tolerate therapeutic doses of sulfasalazine. The most common problems are dose-related and include nausea, gastrointestinal upset, headaches, arthralgias, myalgias, bone marrow suppression, and malaise. Hypersensitivity to sulfapyridine (or, rarely, 5-ASA) can result in fever, exfoliative dermatitis, pancreatitis, pneumonitis, hemolytic anemia, pericarditis, or hepatitis. Sulfasalazine has also been associated with oligospermia, which reverses upon discontinuation of the drug. Sulfasalazine impairs folate absorption and processing hence, dietary supplementation with 1 mg/d folic acid is recommended. 

Med J Australia 31, 104-06 (1944) CA 38, 4805 (1944) (The incidence of Tetryl dermatitis, known as "CE Rash ) 11)W.F. von Oettingen et al, Toxicity and Potential Dangers of Penta-Erythri-tol-Tetranitrate (PETN) , US Public Health Service Bulletin 282 (1944) 12)R-F.Sievers et al,... 

The local adverse effects of inhaled glucocorticoids have been studied in a prospective, cross-sectional, cohort study in 639 asthmatic children using beclomethasone (721 micrograms/day) or budesonide (835 micrograms/ day) for at least one month (28). The local adverse effects included cough (40%), thirst (22%), hoarseness (14%), dysphonia (11%), oral candidiasis (11%), perioral dermatitis (2.9%), and tongue hypertrophy (0.1%). A spacer doubled the incidence of coughing. 

In principle, all forms of the well-known iodine-induced allergic reactions, such as iododerma tuberosum, dermatitis, petechiae, and sialadenitis are possible with povidone-iodine, but the incidence seems to be very low (SEDA-11, 489 SEDA-12, 586 4,31,32). 

Sulfur. Symptoms of sulfur exposure were dermatitis and eye irritation. Incidents generally occurred within 1 to 4 days after application, but have occurred up to 3 weeks after application during mowing operations. 

Carbamates (carbaryl, benomyl, carbofuran, aldicarb, methomyl). Symptoms of exposure were nausea, dizziness, b listers, dermatitis, malaise, sweating, tearing, breathing difficulty, and chest tightness. Usually, incidents have occurred within 1 to 2 days after application except for aldicarb (up to 4 days after application). 

Following oral ingestion, adverse effects may include nausea (6%), hypotension (1.3%), allergy (1.1%), and bleeding (rare). Breath odor has been reported with an incidence of 20-40% at recommended doses using enteric-coated formulations. Contact dermatitis may occur with the handling of raw garlic. 

Although the incidence of adverse reactions to mupirocin is typically low (occurring in less than 1.5% of patients), several local side effects such as burning, stinging, pain, erythema, and contact dermatitis have been reported. Resistance to mupirocin has been reported but is not common. Some strains of bacteria have a low level of resistance but succumb to high-dose of mupirocin.14 Due to this fact, it should be handled with extreme care, especially as prophylactic use, in order to prevent further resistance. 

Tosti, A., Vincenzi, C., Trevisi, P, and Guerra, L., Euxyl K400 incidence of sensitization, patch test concentration and vehicle, Contact Dermatitis, 33, 193, 1995. 

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